KHN’s consumer columnist answers questions about the effects a change of income can have on an individual’s subsidy for insurance premiums and dental care for Medicare beneficiaries. (Michelle Andrews,
12/8)

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Summaries Of The News:

The administration offered uninsured consumers a reprieve if they missed the 2015 enrollment deadline, but officials said that wouldn't be repeated this year. Also in health law news, a new government survey looks at the effect of medical bills on consumers, HHS Secretary Sylvia Mathews Burwell's mission for the rest of her term and an insurance executive's views of the changing market landscape.

The Wall Street Journal:
Health-Law Avoiders Won’t Get Reprieve This Time Around
Federal officials said Monday that if uninsured people don’t obtain coverage within the health law’s official enrollment period, which ends Jan. 31, they won’t get an extension to avoid the law’s penalty for going without insurance this time around. Earlier this year, the Obama administration offered uninsured people a reprieve if they missed the sign-up deadline for 2015 coverage, originally set at Feb. 15. People were given through April to sign up if they said they had learned about the penalty for going uninsured only when they filed their taxes. (Radnofsky, 12/7)

The Associated Press:
Gov't Survey: Fewer Americans Struggle To Pay Medical Bills
For the fourth straight year fewer Americans are struggling to pay medical bills, according to a major government survey released Tuesday. Most of the progress has come among low-income people and those with government coverage. The data from the Centers for Disease Control and Prevention show that the number of people in households that faced problems paying medical bills decreased by 12 million from the first half of 2011 through the first six months of this year. (Alonso-Zaldivar, 12/8)

Bloomberg:
The Woman Who Has 13 Months To Bolster Obamacare
The woman in charge of Barack Obama’s health-care overhaul is counting down the days: She has 414 to go in the Obama administration. Sylvia Mathews Burwell, secretary of the Department of Health and Human Services, is trying to cram in what she can, while she can, as she works to secure the fate of the president’s signature domestic policy accomplishment, the Affordable Care Act. (Tracer and Winkler, 12/5)

These waivers allow states to create a Medicaid expansion that fits their political outlooks. Also, news outlets examine Medicaid expansion news in Kentucky, Ohio, Louisiana and Idaho.

Modern Healthcare:
Waivers Are New Battlefront In Republican-Led States That Expanded Medicaid
Providers, patients and lawmakers in Arizona and Iowa are urging the CMS to reject Medicaid changes proposed by Republican governors. But in Michigan, the same array of stakeholders wants the CMS to allow conservative provisions to save the state's Medicaid expansion. That's because when Michigan lawmakers passed legislation in 2013 expanding Medicaid eligibility in the state, they included a clause requiring the expansion to sunset in 2016 unless the CMS accepts provisions such as sharp increases in premiums and cost-sharing obligations. (Dickson, 12/7)

WOSU (Columbus, Ohio):
Medicaid Expansion Helps Inmates Get Health Care
Someone who’s preparing to get out of prison has a lot to think about. They have to find housing, a job, transportation. Health care often falls to the wayside. But the state’s corrections department has begun to help inmates find insurance before they’re released. Ohio’s decision to expand Medicaid plays a key role. Each year, roughly 20,000 people are released from Ohio prisons. They haven’t left with much as far as health care is concerned. ... But then Governor John Kasich expanded Medicaid. With income eligibility raised, more inmates would qualify. ... The pre-release Medicaid enrollment pilot program began at the women’s prison, in Marysville, 15 months ago. About 90 days before their parole dates, inmates are introduced to the different programs offered in Ohio. A few days later, a Medicaid agent enrolls them over the phone. (Trimble, 12/7)

New Orleans Times-Picayune:
State Senate Finance Committee Asks For Report On Medicaid Expansion
Senate Finance Committee members asked the Department of Health and Hospitals on Monday (Dec. 7) to produce a report outlining Louisiana's options for expanding Medicaid, to be delivered by Jan. 1. Monday's meeting was the second time the committee has met about the rising costs of health care in Louisiana since the legislative session ended in June. The tone of the meeting was noticeably different than the committee's Oct. 24 session, when Medicaid expansion was not even mentioned by name. (Litten, 12/7)

Idaho Statesman:
State Plan Takes Aim At Idaho’s Health Insurance Coverage Gap
The Otter administration is proposing a state-funded partial alternative to Medicaid expansion that could deliver basic primary care for 78,000 Idahoans who now have little or no access to health care coverage. The Governor’s Office and Department of Health and Welfare personnel have met with state legislators, business groups and health organizations to outline the proposal, the basic details of which call for state payments to primary care providers to cover basic preventive health care for people in the so-called coverage gap — people who earn too much to qualify for Medicaid but not enough to qualify for assistance obtaining health insurance. The payments would amount to about $32 per month per individual covered — roughly $30 million in all. Emergency room visits, acute care, hospitalizations and prescriptions would not be covered, and the state’s existing reliance on county indigent funds and the state catastrophic fund to pay for crisis care would be retained. (Dentzer, 12/4)

Policy riders appear to be the stumbling block. Some leaders are suggesting a stop-gap measure may be necessary to avert a government shutdown, but the White House spokesman said the president would not sign a short-term bill unless an outline for a deal had already been reached.

Politico:
Congress Likely To Blow Budget Deadline
With negotiations over a massive $1.1 trillion budget package moving at a glacial pace, GOP leaders are now openly predicting that Congress will blow past a Dec. 11 deadline for funding the federal government. Both sides appear to be notching wins in the high-stakes talks. Republicans are confident they'll be able to lift a ban on exporting crude oil, though the GOP is wary of acceding to Democratic demands on environmental policy in return for allowing such sales. Democrats are relieved Republicans aren't fighting to strip funds from Planned Parenthood. (Bresnahan and Sherman, 12/7)

The Wall Street Journal:
Stopgap U.S. Spending Bill May Be Needed, GOP’s Kevin McCarthy Says
Congress may need to pass a stopgap measure keeping the government running for just a few days to avoid a partial shutdown when its funding expires at week’s end, a House GOP leader said Monday. ... Lawmakers have largely agreed on the funding levels for different parts of the government set by the spending bill, known as the omnibus, but are still wrangling over which other policy measures get attached to it. ... Many lawmakers had hoped to reach a deal making some of the tax breaks permanent, but it remained uncertain Monday whether lawmakers would strike a long-term agreement or simply extend the measures for two years. A bigger deal may also include delays of the 2010 health law’s medical device tax and so-called “Cadillac tax” on high-cost, employer-sponsored health insurance. (Peterson and Nelson, 12/7)

The Washington Post:
Negotiations Over Year-End Spending Bill Hit A Tax Snag
After days of scrambling to hammer out an agreement, negotiators are still deadlocked over several policy riders that GOP lawmakers want to attach to the must-pass legislation as well as over what do with a package of tax breaks that could also be added to the bill. White House spokesman Joshua Earnest told reporters that President Obama would not sign a short-term CR in order to give negotiators more time to strike a deal. If lawmakers reach an agreement before Friday, however, Earnest did not rule out the possibility of agreeing to a stop-gap bill to give Congress time to finish procedural work. (Snell, 12/7)

On the topic of Planned Parenthood -

The Huffington Post:
Republicans Insist Planned Parenthood Committee Isn't Specifically Targeting Planned Parenthood
Ever since a gunman on a shooting rampage killed three people at a Planned Parenthood clinic late last month, Republicans on the select panel convened to investigate Planned Parenthood have been insisting that the committee isn't targeting the nation's largest abortion provider. In the wake of the Colorado Springs shooting, Democrats have called for the committee to be disbanded. ... The Republican response has been to point out that the October resolution establishing the special committee referred generally to "abortion providers," but not Planned Parenthood. (Lachman, 12/7)

Also, Rep. John Fleming throws his hat into the Louisiana Senate race -

The Zadroga 9/11 Health and Compensation Act, which expired last year, provides health care funding and compensation for first responders. The program has enough funding to last another year, and its backers are seeking a permanent extension.

The Associated Press:
Stewart Returns To 'Daily Show' To Push 9/11 Health Act
Comedian Jon Stewart has returned to "The Daily Show" where he made a push to renew a law that provides health benefits for first responders who became ill after the Sept. 11 terror attacks. ... Proponents of the law are seeking its permanent extension, but some Republicans have opposed that, saying they want a chance to periodically review it and make sure it's operating soundly. (12/7)

The New York Times:
Jon Stewart Returns To ‘The Daily Show’ For Zadroga Act
That issue, Mr. Stewart said, was the James Zadroga 9/11 Health and Compensation Act, which provides health care funding and compensation for emergency workers who were sickened by the terrorist attacks of Sept. 11 and their aftermath. The act passed Congress in 2010, was signed into law by President Obama and went into effect the following year. Portions of the act expired after Sept. 30, and the rest of it will expire by next October unless it is renewed. (Itzkoff, 12/8)

Even so, physician Karen DeSalvo, acting assistant secretary of health at the Department of Health and Human Services, said this investment plays a big role in keeping Americans healthy. Meanwhile, news outlets report on a range of public health issues, including the Alzheimer's risk of some prostate-cancer drugs, the rising incidence of the "phantom menace" superbug and HIV infection rates.

USA Today:
Public Health Gets Least Money, But Does Most
Just three cents of each U.S. health care dollar goes to public health even though it plays a far bigger role in keeping Americans well than medical care, a top federal official said at a forum sponsored by USA TODAY and insurer Cigna. State and local public health departments were hit especially hard by the recession and haven't recovered, said physician Karen DeSalvo, acting assistant secretary of health at the Department of Health and Human Services. (O'Donnell and Ungar, 12/7)

The Wall Street Journal:
Study Warns Of Alzheimer’s Risk In Some Prostate-Cancer Drugs
Men taking testosterone-blocking drugs to treat prostate cancer have nearly twice the risk of developing Alzheimer’s disease as those using other treatments, according to an analysis of electronic medical records published Monday. Androgen-deprivation therapy—also known as chemical castration—lowers levels of testosterone and other male hormones that can fuel the growth of prostate cancer. (Beck, 12/7)

The Washington Post:
Superbug Known As ‘Phantom Menace’ On The Rise In U.S.
A particularly dangerous superbug, dubbed the "phantom menace" by scientists, is on the rise in the United States, according to a report Thursday by the Centers for Disease Control and Prevention. This superbug's strains belong to the family of bacteria known as CRE, which are difficult to treat because they are often resistant to most antibiotics. They are often deadly, too, in some instances killing up to 50 percent of patients who become infected, according to the CDC. Health officials have called CRE among the country's most urgent public health threats. (Sun, 12/4)

The Associated Press:
New HIV Infections In Gay Black Men May Be Leveling Off
New HIV infections in gay black men may finally be leveling off, health officials reported Sunday. Overall, new cases of HIV have been falling in the United States, while the number has been growing in gay and bisexual black men. The AIDS virus is far more common in that group. But new figures released Sunday show that the number of newly diagnosed cases in gay and bisexual black men hasn't moved up much since 2010 — less than 1 percent. For younger men in that group — who have had alarming infection rates — new diagnoses dropped 2 percent. (Stobbe, 12/6)

In addition, the Food and Drug Administration approves a generic leukemia pill -

The Associated Press:
FDA OKs First Generic Version Of Leukemia Pill
U.S. regulators have approved the first generic version of one of the first very effective — and expensive — cancer drugs, Gleevec, which costs about $10,000 a month. The Food and Drug Administration (FDA) granted a subsidiary of Indian drugmaker Sun Pharmaceutical Industries Ltd. approval to sell generic Gleevec, known as imatinib mesylate, in 100-milligram and 400-milligram pills for chronic myeloid leukemia. (Johnson, 12/4)

Reuters reports that some state laws, which were designed to protect drug-dependent babies, put the mother in legal trouble, leading some doctors to avoid certain referrals. In a separate story, Reuters reports on patterns in which these at-risk babies, once released from the hospital, have a greater risk of mortality.

Reuters:
State Policies Deter Doctors From Reporting Drug-Endangered Babies
When Congress adopted the Keeping Children and Families Safe Act in 2003, the intent – spelled out in the law – was to ensure protection for drug-dependent newborns, not to punish mothers battling addiction. But today, a referral to child protection services in some states can put a mother in legal peril – a reality that dissuades some doctors from reporting cases of newborns in drug withdrawal no matter what the federal provisions intended. (Wilson and Shiffman, 12/8)

Reuters:
Newborns Die After Being Sent Home With Drug-Dependent Mothers
Brayden Cummings turned 6 weeks old the morning his mother suffocated him. High on methamphetamine, Xanax and the methadone prescribed to help her kick a heroin habit, 20-year-old Tory Schlier told police that she was “fuzzy” about what happened to her baby boy. A 12-year-old federal law calls on states to take steps to safeguard babies like Brayden after they leave the hospital. That effort is failing across the nation, a Reuters investigation has found, endangering a generation of children born into America’s growing addiction to heroin and opioids. (Wilson and Shiffman, 12/8)

American HomePatient, a company that specializes in respiratory health care and had sales of $280 million last year, has faced financial pressure because of government budget cuts. Also in the news, SAP showcases its software for doctor data sharing.

Bloomberg:
Linde To Buy U.S. Respiratory Care Company American HomePatient
Linde AG agreed to buy respiratory health-care specialist American HomePatient Inc. to expand a medical-gas business in the U.S. that’s under pressure from government budget cuts. American HomePatient, based in Brentwood, Tennessee, had sales of $280 million in the last fiscal year, Munich-based Linde said Monday in a statement. Linde is expanding the operation to benefit from an aging population even though the company said this month that cuts in Medicare, the government program that provides health services to the elderly, will hurt earnings in the next few years. (Matthews, 12/7)

Bloomberg:
SAP Unveils Software For Doctor Data-Sharing After CEO Accident
SAP SE Chief Executive Bill McDermott is back traveling and attending meetings after finding out in September he’d lose an eye following a severe household accident in July. Based on his recovery experience, the CEO is moving the German business software company deeper into programs that can improve communications and information sharing for doctors. SAP on Tuesday announced Foundation for Health, a new product that lets doctors and researchers collect and analyze medical data such as research, electronic health records and human genome sequences in a single system. The idea is to let doctors and researchers customize new drugs and treatments for individuals as well as groups. (Ricadela and Matthews, 12/8)

Kansas Gov. Sam Brownback, who faced a serious state deficit after cutting state taxes, tripled the tax on managed care companies and used that extra revenue to draw down more federal Medicaid funds and help stabilize his budget. In Iowa, state officials are working to overcome concerns about a shift to managed care in the Medicaid program.

Bloomberg Businessweek:
Another Way For States To Get Federal Help
Sam Brownback is among the 19 Republican governors who have consistently refused extra federal dollars under the Affordable Care Act to expand Medicaid for the poor. A Tea Party darling, Brownback of Kansas also cut his state’s income taxes three years ago, promising to make up the revenue through increased economic growth that never came. This year, facing a budget shortfall of more than $600 million, he decided to fill some of the gap using a strategy designed to draw more federal dollars to his state—through Medicaid. ... Brownback tripled the tax on managed-care groups, to 3.1 percent, and increased state spending by $33.4 million. With a federal match of $1.27 for every dollar Kansas spent, the gambit netted the state a bonus $47 million for its general fund. (Newkirk, 12/4)

Des Moines Register:
Iowa Asks Out-Of-Staters To Tout Benefits Of Privatized Medicaid
The Iowa Department of Human Services tried to put a positive face on Medicaid privatization Monday, asking each of the companies it has contracted with to bring out-of-state residents to tout their experiences to Iowa lawmakers. "Who better for lawmakers to hear from than people who have received coverage from these very companies and experienced first-hand managed care addressing their complex needs?" asked department spokeswoman Amy Lorentzen McCoy. The travel costs were paid by the companies and not the state, Lorentzen McCoy said. (Clayworth, 12/7)

The report, issued by the National Alliance on Mental Illness, found that 23 states have increased money for mental health services in 2015 while the others decreased or kept funding level. Connecticut, the site of the school shooting, is among the states that have increased resources.

The Washington Post:
Three Years After Sandy Hook, More States Cut Mental Health Funding
Three years after the Sandy Hook mass shooting prompted public demands for mental health care reform, an increasing number of states have cut funding for mental health services, according to a report released Tuesday by a mental health advocacy group. The report by the National Alliance on Mental Illness said only 23 states increased mental health spending in 2015, compared to 36 states in 2013 and 29 in 2014. (Sun, 12/8)

The Associated Press:
Report: Connecticut Boosted Mental Health Funding In 3 Years
Connecticut is one of 11 states that have increased funding for mental health care every year since the 2012 mass shooting at Sandy Hook Elementary School, according to a new national report. The report released Tuesday also lauds the state for passing legislation that clarifies individual health plans must cover "nervous conditions" and school-based health programs include screening for behavioral or disciplinary problems. (Haigh, 12/6)

In related news -

The Boston Globe:
People With Mental Illness Don’t See Benefits From New Health Care Payments, Study Finds
New methods of paying for health care, designed to improve care while controlling costs, have failed to help a big segment of the population — those grappling with mental illness — a Harvard Medical School study says. Published Monday in the journal Health Affairs, it said the Alternative Quality Contract, a payment system run by Blue Cross Blue Shield of Massachusetts, is not improving care or saving money for the mentally ill. (Dayal McCluksey, 12/8)

Elsewhere, a federal appeals panel rejects a lawsuit filed by a Pennsylvania hospital against Medicare's payment structure for skilled nurses. And the U.S. Supreme Court will hear a case on whether providers who bill Medicaid imply they are following program requirements such as licensing and supervising staff.

Reuters:
8th Circuit Upholds Union For Minnesota Home Care Providers
A Minnesota law that created a union for home health providers for Medicaid recipients does not violate the state or U.S. constitutions, a federal appeals court held Thursday. A unanimous three-judge panel of the 8th U.S. Circuit Court of Appeals affirmed a ruling by a federal judge in Minneapolis that dismissed a 2014 lawsuit by six home health providers who sought to block the 2013 Individual Providers of Direct Support Services Representation Act. Similar laws are in place in California, Connecticut, Maryland and several other states. (Grzincic, 12/5)

Reuters:
Panel Rejects Pennsylvania Hospital's Medicare Payment Challenge
A federal appeals panel has upheld the dismissal of a lawsuit brought by a Pennsylvania hospital against the federal government claiming Medicare underpaid it for skilled nursing services. A three-judge panel of the District of Columbia Circuit Court of Appeals on Tuesday said the lawsuit, filed by Canonsburg General Hospital, was barred by an earlier lawsuit the hospital brought over the same issue, in an opinion written by Circuit Judge Karen LeCraft Henderson. (Pierson, 12/4)

Reuters:
Supreme Court To Review 'Implied Certification' In Medicaid Suits
The U.S. Supreme Court agreed Friday to review the issue of whether healthcare providers who bill Medicaid and other government programs imply they are following all program requirements in so doing, including requirements for licensing and supervising their staff. So-called implied certification has been the basis for a number of whistleblower suits under the U.S. False Claims Act. The case the high court has chosen to take up was brought by Julio Escobar and his wife, Carmen Correa, the parents of a teenager who died of a seizure after being treated at a Lawrence, Massachusetts, mental-health center owned by Universal Health Services Inc. (Grzincic, 12/8)

The Connecticut Mirror:
Critics Seek Hard Look At Yale–L+M Deal, Hospital Market Power
A group of unions and advocacy organizations are calling for state regulators to take a hard look at the growth in power and market concentration of large health systems in Connecticut – and what that means for patients – when they review the Yale New Haven Health System’s proposed acquisition of New London’s Lawrence + Memorial Hospital. (Levin Becker, 12/8)

The Seattle Times:
Group Health Acquisition By Kaiser Draws Worry And Praise
Reaction was swift — and mixed — Friday after the announcement that Seattle’s homegrown medical cooperative, Group Health, may be acquired by the California behemoth Kaiser Permanente. Callers buzzed phone lines at Group Health’s administrative offices as well as the satellite centers throughout Washington and Northern Idaho, officials said. Employees huddled with colleagues and managers. Hundreds of conversations ensued, even as officials said no change in care or coverage is immediately planned. (Aleccia, 12/7)

Connecticut Mirror:
CT Deficit Plan Taps Many Special Funds And One-Time Sources
While the General Assembly is expected to adopt a plan in special session Tuesday to close most or all of this fiscal year’s budget deficit, restore some funds for hospitals and finance modest business tax breaks, almost 40 percent of the plan diverts resources from specialized funds and various one-time sources. (Phaneuf, 12/7)

The Seattle Times:
Norovirus Outbreak Suspected At Downtown Seattle Tower
The cafeteria inside Russell Investments Center in downtown Seattle closed Friday amid a possible outbreak of norovirus that may involve hundreds of people. Public Health — Seattle & King County first began getting calls about illnesses Thursday afternoon, and on Friday visited the building at 1301 Second Ave. Officials are looking at the cafeteria, which closed voluntarily, as one place the virus could have spread, Public Health spokesman James Apa said. The cafeteria is not open to the public. There have been no reports of seriously ill people or hospitalizations, he said. (Garnick, 12/6)

KQED:
Catholic Hospital In Redding Denies Two Women Tubal Ligation
Redding’s Mercy Medical Center has refused — for the second time in four months — to allow doctors to perform sterilization on two pregnant women. The women requested the procedure be done immediately after they give birth next year. The hospital cited religious reasons. The American Civil Liberties Union and Physicians for Reproductive Health have sent a letter to Dignity Health, which owns Mercy Medical, saying they will go to court if the issue is not resolved by Wednesday evening. (Aliferis, 12/7)

The Associated Press:
Catholic Hospital Under Fire For Denying Sterilizations
A Northern California Catholic hospital is under fire again for refusing to allow doctors to perform sterilizations on two pregnant women after they give birth, citing religious reasons. The two women may go to court unless Mercy Medical Center changes its mind by Wednesday, the San Francisco Chronicle reported Monday. (12/7)

Bloomberg:
Puerto Rico Says Sick Will Head North Without Health-Care Fix
Puerto Rico’s elected officials have a message for their counterparts on the mainland: Fix health-care funding disparities or care for our poor and elderly in your hospitals.
Almost 70 percent of the island’s 3.5 million people get health care through Medicaid, Medicare and Medicare Advantage. Funding formulas for these federal programs shortchange Puerto Rico because it’s not a state, commonwealth officials say. (Braun, 12/7)

Minnesota Public Radio:
MN Study: Hospital Ventilator Noise Puts Preemie Hearing At Risk
It's an exceptionally busy day at the Minneapolis neonatal intensive care unit at Children's Hospitals and Clinics of Minnesota. But even in the midst of a harried shift, the staff tries to keep the unit as quiet as possible for their struggling newborns. At the center of the room is an infant who will spend months in here. She was born three months early and is no bigger than her nurse's hands. (Benson, 12/7)

National Review:
A Clear Path For Repealing And Replacing Obamacare Is Coming Into View
House and Senate leaders deserve a lot of credit for putting together a bill that repeals much of Obamacare and skillfully navigating it through both chambers using the budget-reconciliation process. That’s no small achievement, though President Obama is sure to veto the bill as soon as it reaches his desk. But it’s likely to be only a partial preview of what could happen in 2017 — if a Republican wins the White House. It is telling that the bill Congress is poised to send to President Obama delays repeal of Obamacare’s Medicaid expansion and health-insurance subsidies for two years. That way, Republican senators could promise their constituents that a replacement for Obamacare would be put in place before the federal funding for their plans was withdrawn. (James C. Capretta, 12/6)

Health Affairs:
The $879 Billion Footnote — And The Financing Path To ACA Repeal
The November 3 election of Matt Bevin as governor of Kentucky will provide an important indication of the seriousness of Republican intentions to undermine and repeal the health insurance expansions of the Affordable Care Act (ACA). Early in Bevin’s campaign, he expressed unambiguous intent to repeal Governor Steve Beshear’s executive order that expanded Medicaid; during the general election campaign, Bevin backpedaled and proposed adopting an Indiana-like Medicaid waiver to require significant enrollee cost sharing and an enrollment freeze. (John McDonough and Max Fletcher, 12/4)

Modern Healthcare:
Tackle Gun Violence Like Other Public Health Problems
San Bernardino, Calif., Colorado Springs, Colo., Roseburg, Ore., Charleston, S.C., Watertown, Conn., Aurora, Colo., Blacksburg, Va. The routinization of mass murder in the U.S. continues apace. The overall statistics may not show an increase in the number of Americans killed by firearms each year. But the horrific nature of recent mass slaughters reveals a tragic truth: The proliferation of guns in our society has been, and continues to be, one of the nation's leading threats to public health. (Merrill Goozner, 12/5)

Health Affairs:
The Impact Of New Hepatitis C Drugs On National Health Spending
Many analysts had predicted ... an increased health spending growth rate for 2014 due to the implementation of the Patient Protection and Affordable Care Act (ACA). ... However, the huge jump in prescription drug spending that occurred in 2014 was unforeseen. In 2013, spending on prescription drugs grew by only 2.4 percent, but in 2014, it skyrocketed to 12.2 percent. Some of this increase in spending on prescription drugs is due to expanded coverage, and some is due to the acceleration in prescription drug prices. A major source of this growth was the introduction of Sovaldi in December 2013, and Harvoni in October 2014. Both are very expensive breakthrough drugs for the treatment of hepatitis C. (Charles Roehrig, 12/7)

Health Affairs:
Nothing (Still) Matters: ERISA Preemption Returns To The Supreme Court
It’s back. After more than a decade without a major health care dispute involving the Employee Retirement Income Security Act of 1974 (ERISA) reaching the United States Supreme Court, the justices heard oral arguments on December 2 in Gobeille v. Liberty Mutual Insurance Co. The case involves a challenge by a national employer that self-insures health coverage for its workforce to the validity of a Vermont law requiring comprehensive health care claims data to be reported to the state’s “All-Payer Claims Database.” Following its progress through the courts reminds me why—throughout the 1990s and into the 2000s—I explained to every class of Health Law students I taught that ERISA was the most important law affecting private health insurance in the United States. (William Sage, 12/7)

The New York Times Upshot:
Your New Medical Team: Algorithms And Physicians
Can machines outperform doctors? Not yet. But in some areas of medicine, they can make the care doctors deliver better. Humans repeatedly fail where computers — or humans behaving a little bit more like computers — can help. Even doctors, some of the smartest and best-trained professionals, can be forgetful, fallible and prone to distraction. These statistics might be disquieting for anyone scheduled for surgery: One in about 100,000 operations is on the wrong body part. In one in 10,000, a foreign object — like a surgical tool — is accidentally left inside the body. Something as simple as a checklist — a very low tech-type of automation — can reduce such errors. (Austin Frakt, 12/7)

JAMA Internal Medicine:
Research In Medical Education And Patient-Centered Outcomes
Can medical education, at any level (undergraduate, graduate, or continuing), be evidence-based? Regardless of the field of research, whether medical education or clinical outcomes, the most compelling form of evidence comes from large, randomized clinical trials (RCTs) or large, prospective cohort studies. When it comes to high-stakes decisions about interventions that will involve large populations, we expect rigorous evidence to guide decision-making. Why would we have different expectations regarding the level of evidence for medical education research than we do for clinical research? (Patrick G. O’Malley and Louis N. Pangaro, 12/7)